But on other votes LMC leaders were flexing their muscles. They mandated GPC to explore whether the union should withdraw from the national pay review process that delivered practices disappointing 0.28% funding uplift this year. The motion gave negotiators a strong hand to look at ‘explor[ing] whether we should continue to participate with the DDRB process’, following a series of ‘unbelievable’ pay awards.

This is a marked change from previous BMA policy, that concentrated on the GPC asking for a change to the way the DDRB calculated pay awards. It seems the profession has lost faith in the process which continually underestimates practice expenses and where a secretary of state is able to accept low awards and reject higher ones on a whim.

And it looks as though this has come at a time when the GPC leadership is beginning to roar. GPC chair Dr Chaand Nagpaul has until now taken on a diplomatic style of leadership, which arguably secured some successes in the contract negotiations.